STATE OF NORTH CAROLINA
IN THE GENERAL COURT OF JUSTICE
DISTRICT COURT DIVISION
BEFORE THE CLERK
____________________COUNTY
______ SP __________
________________________________________________
(Full name of petitioning parent 1)
________________________________________________
(Full name of petitioning parent 2)
DECREE OF ADOPTION
FOR THE ADOPTION OF
________________________________________________
(Full name by which adoptee is to be known)
This cause coming on to be heard and being heard before the undersigned and the Court from all the evidence presented
in this proceeding, enters the following Decree of Adoption. The Court finds by a preponderance of the evidence the
following:
1.
That all necessary parties in the above-entitled proceeding are properly before the Court; that notice of the
filing of the Petition was served on all required persons and that the time for filing a response has expired;
2.
That the above-named ___________ child was born on ___________________________________________
(Sex)
(Month)
(Day)
(Year)
in ______________________________________________________;
(State/Country)
3.
That said child was placed with petitioner(s) for adoption on the _______ day of _____________________,
_________, or the placement requirement has been waived; and each necessary consent, relinquishment, waiver, or
judicial order terminating parental rights has been obtained and filed with the Court and the time for revocation has
expired.  The consent of the minor child 12 or more years old is hereby dispensed with as the Court finds it is not in
the minor's best interest to require the consent;
4.
That said child has been in the physical custody of the petitioner(s) for at least 90 days or this requirement has
been waived by the Court for cause;
5.
That a duly verified Petition for Adoption of said child was filed with this Court by the above-named
petitioner(s) on the ______________ day of _______________________________________, ____________;
6.
That at least 90 days have elapsed since the filing of the Petition for Adoption or this requirement has been
waived by the Court for cause;
7.
That the marital status and gender of the petitioner(s) is/are: ______________________________________
___________________________________________________________________________________________;
(Enter whether married, stepparent, single, and petitioners genders)
8.
That any assessment required by Chapter 48 has been filed with and considered by the Court;
9.
That, if applicable, the requirements of the Interstate Compact on the Placement of Children, G.S. 7B-3800, et.
seq., have been met or have been waived pursuant to G.S. 48-2-603(b).
10.
Any motion to dismiss this adoption proceeding has been denied;
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Children's Services
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11.
Each petitioner is a suitable adoptive parent and the petitioner(s) seeking adoption (is a ) (are) fit person(s) to
have the care and custody of said child and are financially able to provide for the child;
12.
Any accounting and affidavit required under G.S. 48-2-602 has been reviewed by the Court and the Court has
taken appropriate action with regard to any payment or disbursement that violates Article 10 of Chapter 48;
13.
That petitioner(s) has/have received information about the adoptee and the adoptee's biological family if
required by G.S. 48-3-205;
14.
That there has been substantial compliance with the provisions of Chapter 48; and
15.
That the child is a suitable child for adoption and that this adoption is in the best interest of the child;
NOW THEREFORE, it is hereby ordered, adjudged, and decreed by the Court:
(1)
That from the date of the entry of this Decree herein, the said minor is declared adopted for life by
the petitioner(s) and that said child shall henceforth be known by the name of:
_____________________________________________________________________________
and the State Registrar of Vital Records shall make a new birth certificate for said child in
accordance with the provisions of Section 48-9-107 of the General Statutes;
(2)
That the Decree of Adoption effects a complete substitution of families for all legal purposes and
establishes the relationship of parent and child, together with all the rights, responsibilities, and
duties, between each petitioner and the individual being adopted;
(3)
That from the date of this Decree of Adoption, the adoptee is entitled to inherit real and personal
property by, through, and from the adoptive parents in accordance with the statutes on intestate
succession and has the same legal status, including all legal rights and obligations of any kind
whatsoever, as a child born the legitimate child of the adoptive parents;
(4)
That the Decree of Adoption severs the relationship of parent and child between the individual
adopted and that individual's biological  parent 1  parent 2 or  previous adoptive
parents. Further, the former parents are relieved of all legal duties and obligations due from them
to the adoptee, except that a former parent's duty to make past-due payments for child support is
not terminated, and the former parents are divested of all rights with respect to the adoptee.
Notwithstanding any other provision, neither an adoption by a stepparent nor a readoption
pursuant to G.S. 48-6-102, has any effect on the relationship between the child and the parent who
is or was the stepparent's spouse.
This ________________ day of ___________________________________, _____________.
____________________________________________________
Clerk Superior Court
(S E A L)
_______________________________________________County
NOTE:
Four DSS-1814 forms are completed. The original is retained in the Clerk of Superior Court's office; one copy is given
to adoptive parents; one copy is given to the Director of Social Services or licensed private child-placing agency; and
one copy is to be forwarded, along with originals of all other documents except a copy of the Petition, filed in
proceeding, within ten days or the disposition of any appeal taken pursuant to G.S. 48-2-607(b) by the Clerk of Court to
the Division of Social Services, State Department of Health and Human Services.
DSS-1814 (Rev. 11/2014)
Child Welfare Services
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